Background
COVID-19 can be transmitted directly through respiratory droplets or indirectly through fomites. SARS-CoV-2 has been detected on various environmental surfaces, air samples and sewage in hospital and community settings.
Methods
Environmental samples were collected from a ferryboat during a COVID-19 ongoing outbreak investigation and a nursing home and from three COVID-19 isolation hospital wards and a long-term care facility where asymptomatic COVID-19 cases were isolated. Samples were tested by real-time reverse transcriptase–polymerase chain reaction.
Results
SARS-CoV-2 was detected on swab samples taken from surfaces of food preparation and service areas, hospital isolation wards, an air exhaust duct screen, air-conditioning filter, sewage treatment unit and air sample during investigations conducted in response to COVID-19 outbreaks on a ferryboat, nursing home, isolation facility and COVID-19 hospital wards.
Discussion
Food preparation areas and utensils can be contaminated during COVID-19 outbreaks. Respiratory droplets/nuclei from infected persons can be displaced by the air flow and deposited on surfaces. It can be assumed that in the same manner, air flow could transfer and deposit infected respiratory droplets/nuclei from infected persons to the mucous membranes of persons standing against the air flow direction.
Passengers on repatriation flights to Greece from the UK, Spain and Turkey were screened with oropharyngeal swabs on arrival for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Despite almost all passengers being asymptomatic, many tested positive (3.6% from the UK, 6.3% from Spain and 6.3% from Turkey), indicating widespread transmission of SARS-CoV-2 in these countries.
Objective
We reported the alveolar bone histology prior to dental extractions in cancer patients, who received bone‐targeting agents (BTA).
Subjects and Methods
Fifty‐four patients were included. Patients underwent extractions, and bone biopsies were taken.
Results
Extractions were performed due to pain, swelling, purulence, fistula, and numbness, not responding to treatment, in 40 patients (group A); extractions due to asymptomatic, non‐restorable teeth, were performed in 14 patients (group B). Complete alveolar jaw bone histological necrosis was observed in 28 of 40 (70%) patients of group A and none of group B (p < .001). The development of clinical osteonecrosis (MRON) was assessed in 44 patients; 10 patients, who were also treated with Low Level Laser Treatments‐LLLT, were excluded from this analysis, as the alternative therapies were a confounding factor. Twelve patients, with alveolar bone histological necrosis prior to extraction, developed medication‐related osteonecrosis of the jaw (MRONJ) compared with two patients with vital or mixed vital/non‐vital bone (p < .0007). BTAs >1 year and concurrent targeted therapy were also significantly associated with MRONJ (p = .016 and p = .050).
Conclusion
Pain, swelling, purulence, fistula, and numbness were significantly associated with complete bone histological necrosis prior to extractions and increased MRONJ development. Research is justified to explore whether histological necrosis represents an early stage of osteonecrosis.
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